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<title>友邦保险</title>
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<script language="javascript" src="js/jquery.js"></script>
<script language="javascript" src="js/pcasunzip.js"></script>
<script language="javascript">
function ajaxSubmit()
{
	var province3 = $("select[name='province3']");
	var city3 = $("select[name='city3']");
	var pho = $("input[name='pho']");
	var name = $("input[name='name']");
	var validate = $("input[name='validate']");
	var sex = $("select[name='sex']");
	var birthy = $("select[name='birthy']");
	var birthm = $("select[name='birthm']");
	var lang = $("select[name='lang']");
	if(name.val() == '')  
	{
		alert('请输入姓名');
		name[0].focus();
		return false;
	}else if(sex.val() == '')  
	{
		alert('请选择性别');
		sex[0].focus();
		return false;
	}
	else if(birthy.val() == '')  
	{
		alert('请选择年');
		birthy[0].focus();
		return false;
	}
	else if(birthm.val() == '')  
	{
		alert('请选择月');
		birthm[0].focus();
		return false;
	}
	else if(pho.val() == '')  
	{
		alert('请输入手机');
		pho[0].focus();
		return false;
	}else if(province3.val() == "省" || province3.val() == "" ) 
	{  
		alert('请选择省');
		province3[0].focus();
		return false;
	}
	else if(city3.val() == "市"  || city3.val() == "") 
	{  
		alert('请选择市');
		city3[0].focus();
		return false;
	}else if(lang.val() == '')  
	{
		alert('请选择常用语言');
		lang[0].focus();
		return false;
	}else if(validate.val() == '')  
	{
		alert('请输入验证码');
		validate[0].focus();
		return false;
	}
	
	var address = province3.val()+'-'+city3.val();
	$("input[name='address']").val(address);
	//发送ajax请求
	$.ajax
	({
		type:"POST",
		dataType:'json',
		cache:false,
		timeout:10000,
		async:false,
		url:"../nmp/nmp.action?t="+(new Date().getTime()),
		data:$("#formid").serialize(),
		success:function(json)
		   {
			  if(json.success==true)
			  {		
				  //alert("提交成功！")
				  window.location.href="ok.action";
			  }
			  else
			  {
				  alert("提交没有成功:"+json.message);
			  }
			},
		error:function(arg1,arg2)
		   {
				alert("浏览器提交失败:" + arg1 + " "+arg2);
		   }
	});
	return false;
}
</script>
<style>

</style>
</head>
<body>
<div class="bigdiv" >
	<div class="">
		<img  src="images/top.jpg"></img>
	</div>
	<div class="intr" >
<p class="big" >18至60周岁均可投保，并可续保至64岁后的首个保险单周年日</p>
<p class="big" >主险保障利益</p>
<p class="small" >1. 意外身故/意外残疾/意外烧伤</p>
<p class="small" >2. 法定节假日双倍给付，最高达80万元</p>
<p class="big" >附加险保障利益</p>
<p class="small" >1. 公共交通意外、学校医院火灾给付双倍主险保额,若同时发生在法定节假日则给付4倍(含主险给付)</p>
<p class="small" >2. 意外伤害医药补偿(无免赔，法定节假日双倍)</p>
<p class="small" >3. 意外全残每月给付(60月)</p>
<p class="small" >4. 意外住院给付(60月)</p>
<p class="small" style=""><span class="redstar">*</span>本次活动仅面向常居地在广东地区（深圳除外）的客户</p>
<p>&nbsp;</p>
<p class="big2" style="">您可以提交以下信息获取相关产品信息：</p>
			
	</div>
	
	<form id="formid" action="" method="post"  name="form1" class="my_form" onsubmit="return false;" style="position: relative; display: block;">
		<input type="hidden" name="address"></input>
		<input type="hidden" name="from" value="dm"></input>
    	<p><span class="redstar">*</span>姓名 :　 <input  type="text" name="name"  placeholder="请输入姓名"   />&nbsp;&nbsp;&nbsp;&nbsp;</p>
    	<p><span class="redstar">*</span>性别 :　 <select name="sex" style="width:190px" ><option value="">请选择</option><option value="M">男</option><option value="F">女</option></select>
    	 &nbsp;&nbsp;&nbsp;&nbsp;</p>
    	<p><span class="redstar">*</span>生日 :　 
	        <select id='birthy' name='birthy' style="width:75px;">
	        	<option value="">请选择</option>
	        	<option value="1953">1953</option> <option value="1954">1954</option> <option value="1955">1955</option> <option value="1956">1956</option> <option value="1957">1957</option> <option value="1958">1958</option> <option value="1959">1959</option> <option value="1960">1960</option> <option value="1961">1961</option> <option value="1962">1962</option> <option value="1963">1963</option> <option value="1964">1964</option> <option value="1965">1965</option> <option value="1966">1966</option> <option value="1967">1967</option> <option value="1968">1968</option> <option value="1969">1969</option> <option value="1970">1970</option> <option value="1971">1971</option> <option value="1972">1972</option> <option value="1973">1973</option> <option value="1974">1974</option> <option value="1975">1975</option> <option value="1976">1976</option> <option value="1977">1977</option> <option value="1978">1978</option> <option value="1979">1979</option> <option value="1980">1980</option> <option value="1981">1981</option> <option value="1982">1982</option> <option value="1983">1983</option> <option value="1984">1984</option> <option value="1985">1985</option> <option value="1986">1986</option> <option value="1987">1987</option> <option value="1988">1988</option> <option value="1989">1989</option> <option value="1990">1990</option> <option value="1991">1991</option> <option value="1992">1992</option> <option value="1993">1993</option> <option value="1994">1994</option> <option value="1995">1995</option> <option value="1996">1996</option> <option value="1997">1997</option> <option value="1998">1998</option> <option value="1999">1999</option> <option value="2000">2000</option> <option value="2001">2001</option> <option value="2002">2002</option> <option value="2003">2003</option> <option value="2004">2004</option> <option value="2005">2005</option> <option value="2006">2006</option> <option value="2007">2007</option> <option value="2008">2008</option> <option value="2009">2009</option> <option value="2010">2010</option> <option value="2011">2011</option> <option value="2012">2012</option> <option value="2013">2013</option> <option value="2014">2014</option>
	        </select>年&nbsp;
	        <select id='birthm'  name='birthm' style="width:75px;">
	        	<option value="">请选择</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
	        </select>月
	       </select>
        </p>
        
     	<p><span class="redstar">*</span>手机 :　 <input type="" name="pho" placeholder="请输入手机"  /></p>
        
        <p><span class="redstar">*</span>所在地 : 
        <select id='c1' name='province3' style="width:75px;"></select>省&nbsp;
        <select id='c2'  name='city3' style="width:75px;"></select>市
        <select id='c3'  name='area3' style="width:75px;display:none"></select>
        </p>
     	<p><span class="redstar">*</span>常用语言 : 
     	<select name="lang" style="width:180px" >
	     	<option value="">请选择</option>
	     	<option value="国语">国语</option>
	     	<option value="粤语">粤语</option>
     	</select>
		<p>
		<span class="redstar">*</span>验证码 : <input type="text" name="validate" style="width:60px;border:1px solid #999;"/>
                <span style="display:inline-block;width:77px;height:23px;vertical-align:top">
                	<image id="server_image" src="../xml/image.action?t=100" style="width:77px;height:23px;"></image>
                </span>
                <span style="color:#6b6b6b;"><a style="color:#6b6b6b; text-decoration: none;" href="#" onclick="$('#server_image').attr('src','../xml/image.action?t='+(new Date()).getTime()); return false;">看不清楚</a></span>
		</p>
        <p style="font-size:11px;color:#d31145">注意：如下拉框显示有误,请关闭UC浏览器的极速模式</p>
  </form>
  
  <div class="">
		<img src="images/pic.jpg"></img>
	</div>
  <table cellpadding="0" cellspacing="0" border="0">
  	<tr>
  		<td><a href="#" onclick="ajaxSubmit(); return false;"><img src="images/btn1.jpg" ></image></a></td><td><a href="tel:4008001008"><img src="images/btn2.jpg" ></image></a></td>
  	</tr>
  </table>
</div>
<script language='javascript'>
new PCAS("province3","city3","area3");
</script>
</body>
</html>